Presence of Microvascular Dysfunction and CHA₂DS₂-VASc Score in Patients with ST-Segment Myocardial Infarction after Primary Percutaneous Coronary Intervention

<b><i>Objective:</i></b> We aimed to investigate the relation between CHA₂DS₂-VASc score and microvascular dysfunction (MVD) assessed by the index of microvascular resistance (IMR) immediately after primary percutaneous intervention (PPCI) for patients with ST-segment elevation myocardial infarction (STEMI). <b><i>Subjects and Methods:</i></b> The study included 115 consecutive patients with STEMI who underwent successful PPCI. Angiographic results of reperfusion were inspected to evaluate the association of high CHA₂DS₂-VASc score and IMR. Also, we assessed echocardiographic changes with respect to CHA₂DS₂-VASc score. <b><i>Results:</i></b> Subjects were stratified into 2 groups based on IMR &#x3c;/≥ 40 U; 72 patients (62.6) with IMR &#x3c;40 U and 43 patients (37.4) with IMR ≥40 U. Patients with IMR ≥40 U had higher CHA₂DS₂-VASc score (<i>p</i> &#x3c; 0.001). CHA₂DS₂-VASc score was significantly correlated with increased left atrial volume index, diastolic dysfunction, wall motion score index, and inversely correlated left ventricular ejection. Moreover, CHA₂DS₂-VASc score was strongly correlated with IMR (<i>p</i> &#x3c; 0.001). At multivariate analysis, low systolic blood pressure, stent diameter, and CHA₂DS₂-VASc score were associated with MVD. Besides, CHA₂DS₂-VASc score ≥4 was the optimal value in predicting MVD (IMR ≥40) in STEMI patients. <b><i>Conclusions:</i></b> The data of the current study point out that increased CHA₂DS₂-VASc score, lower systolic blood pressure &#x3c;90 mm Hg, and stent diameter are associated with increased incidence of MVD (increased IMR) after PPCI of STEMI. We suggest that the CHA₂DS₂-VASc score may be a simple, inexpensive useful risk score for the prediction of MVD risk after PPCI for STEMI patients.